UDC: 617.77-002:616-056.3]-06-07 

Abstract. Blepharitis is a very common disease in ophthalmology, dermatology, and allergist practice. It can be acute or chronic. Acute blepharitis is most often caused by viruses (Herpes simplex and Varicella zoster) and bacteria (Staphylococcus). Chronic blepharitis is a symptom of allergies, metabolic syndromes most often associated with liver disease, autoimmune diseases, fungal infections, and Demodex. The liver is a vital organ that supports immunity, metabolism, digestion, stores vitamins, and is responsible for detoxification. Therefore, liver dysfunction can also cause skin lesions around the eyes. Stress, through the activation of the pituitary-hypothalamic-adrenal system, promotes cell activation and the release of biologically active cytokines, which in turn
is a factor in skin damage. Clinically, blepharitis is manifested by redness, itching, and swelling of the eyelids, sometimes the formation of scales on the eyelids. As a rule, both eyes are affected and the disease has a recurrent course. In most cases, blepharitis does not pose a threat to the patient's life, but it reduces the quality of life and is dangerous for the development of such complications as conjunctival lesions and the formation of corneal marginal ulcers.
The article presents clinical cases of patients with chronic blepharitis who had similar symptoms but differed in etiology and treatment regimens.
Key words: blepharitis, contact dermatitis, toxic blepharitis.

Background and objectives. Recent evidence has demonstrated that mildly elevated bilirubin concentrations are protective against various oxidative stress-mediated diseases, including autoimmune disorders. Based on this, the present study aimed to investigate the association between serum bilirubin levels, albumin-based inflammatory ratios, and the presence of primary antiphospholipid syndrome (APS) in women with a history of spontaneous miscarriages.
Materials and methods. This cross-sectional observational study included 72 women aged 21–40 years (median age 27) with a history of spontaneous miscarriages in the first trimester. Based on clinical and laboratory findings, 47 women were diagnosed with APS, and 25 were classified as non-APS. All participants underwent a complete evaluation, including blood count, coagulation tests, glucose and lipid profiles, CRP, vitamin D, and assessments of thyroid, liver, and kidney function.
Results. A total bilirubin level below 8 μmol/L was observed in 53% of APS patients, significantly higher than in non-APS women (24%, p = 0.024). Total, direct, and indirect bilirubin concentrations were significantly lower, while inflammatory markers such as fibrinogen, CRP, and CRP/albumin ratio were significantly higher in APS patients (p < 0.05). Logistic regression and ROC analysis confirmed the diagnostic value of these markers. The AUC values for total bilirubin, bilirubin/albumin ratio, fibrinogen, albumin/fibrinogen ratio, CRP, and CRP/albumin ratio demonstrated moderate diagnostic
accuracy (AUC = 0.723, 0.793, 0.693, 0.828, 0.761, and 0.699, respectively).
Conclusions. Serum bilirubin levels and the bilirubin/albumin ratio were negatively associated with APS in women with a history of spontaneous miscarriage. These findings suggest impaired antioxidant and anti-inflammatory defenses in APS patients. Serum bilirubin combined with albumin-based inflammatory ratios may serve as additional screening tools for APS in this population.

Keywords: antiphospholipid syndrome, total bilirubin, total bilirubin to albumin ratio, oxidative stress

On December 13–15, 2023, the International Medical Forum (IMF) “Medicine of Ukraine and the World: Fundamentals, Realities and Strategic Prospects” was held in Lviv, during which the 12th Christmas Readings on Immunology and Allergology took place. The event was dedicated to the 150th anniversary of the Shevchenko Scientific Society & the 125th anniversary of the Medical Commission of the Shevchenko Scientific Society [1]. The article highlights key aspects of the plenary session “Improving Patient Access to Treatment in Ukraine: Challenges and New Opportunities for Pharmaceutical Provision in Wartime Conditions”, which was organized within the framework of the International Medical Forum by a strong delegation from the State Expert Center of the Ministry of Health of Ukraine.

УДК 338.5:615.252.349.7

Increasing the availability and affordability of medical and pharmaceuticalcare to the population is the most important task of all levels of government. The purpose of the work is to study the affordability of glucose-lowering drugs for the treatment of type 2 diabetes in Ukraine. Research materials are: State
Register of Medicinal Products and price of glucose-lowering drugs. Marketing, analytical, graphic and pharmacoeconomic analysis were used. On the pharmaceutical market of Ukraine 161 glucose-lowering drugs are registered, which contain 16 international non-proprietary names and 8 international non-proprietary names combinations. It was established that the cost of Defined Daily Dose for mono glucose-lowering drugs varies from UAH 1,1 for glibenclamide up to UAH 90,7 for liraglutide. Most of the Ukrainian-made and foreign drugs are highly affordable, but foreign preparations of modern groups are moderately affordable, only one foreign drug, Liraglutide, is unaffordable ratio. But the analysis of affovailability for pensioners only metformin (Ukrainian production), glibenclamide, gliclazide, and glimepiride are highly affordable, three of which are already subject to reimbursement. Modern glucose-lowering drugs, both of foreign and Ukrainian production, is scarcely affordable, which makes it practically impossible to use them in the majority of retirees with diabetes. Thus, the analysis showed that in order to implement modern treatment schemes for type 2 diabetes, which according to the current
legislation can be used in Ukraine, it is necessary to expand the list of glucose-lowering drugs included in the reimbursement program. This will improve treatment results, which in turn will reduce the development of diabetes complications and improve the quality of life of patients.  

Today there is a danger of spreading Ixodes ticks, which can cause Lyme disease, which is characterized by polysystemic lesions. As a rule, treatment involves antibiotic therapy. We studied the effectiveness of apitherapy by bee sting method in the complex treatment of patients with Lyme arthritis. Patients were prescribed a course of bee stings from 1 to 15 bee stings once every other day, a total of 102 stings. After a course of apitherapy, patients had significantly reduced or eliminated pain in the spine and joints, there was a significant decrease in IgM during bee stings between courses of antibiotic therapy and IgG in tests performed after a course of treatment with bees. Apitherapy can have a pronounced antibacterial effect over the next 2 years. In addition to these findings, further observations indicated that the immunomodulatory effects of bee venom may play a crucial role in mitigating inflammatory responses. Patients not only experienced relief from pain but also reported improved mobility and overall quality of life. The gradual reduction in specific antibody levels suggests that the bee sting treatment may help recalibrate the immune system over time. This additional benefit, coupled with the direct antibacterial properties of the venom, positions apitherapy as a promising complementary treatment approach. Continued research into the long-term effects is warranted to better understand its full therapeutic potential. Moreover, the observed improvements were supported by both subjective patient reports and objective clinical measurements. The treatment appeared to modulate the inflammatory cascade associated with Lyme arthritis, leading to fewer flare-ups and a reduction in joint stiffness. This innovative method also showed potential in preventing further joint degradation, thereby extending its benefit beyond immediate pain relief. Future studies are needed to explore the optimal dosing, frequency, and possible synergies with conventional antibiotic therapies, ensuring that patients receive the most effective comprehensive care.